Antibiotic doses in renal impairment (including guidelines)

Peritoneal Dialysis related Peritonitis - For empirical antibiotic guidance (click here)

(NOTE: please read the disclaimer)

Dosing recommendations are based on creatinine clearance calculated using the Cockcroft-Gault equation.

Do not use eGFR estimates (available on PAS) for drug dosing purposes (for more information click here )

 

To calculate creatinine clearance (CrCl) using the Cockcroft-Gault equation,

use the creatinine clearance calculator :

 

Many elderly patients have a degree of renal impairment, which, because of reduced muscle mass, may not be indicated by a raised serum creatinine level. It is therefore important to calculate the CrCl for this patient group. Anuric and oliguric (<500ml/day) patients can be assumed to have a CrCl < 10ml/min (severe renal impairment).

 

Accurate estimation of CrCl is only possible in patients with STABLE renal function. In patients with rapidly changing renal function (i.e. ACUTE renal failure), the serum creatinine levels will no longer provide a true reflection of renal function.

 

Dose adjustment may not be appropriate in ACUTE renal impairment secondary to SEPSIS. In this case it is important to treat the infection aggressively for the first 24hrs and re-check renal function before reducing the dose accordingly.

(In 'acute on chronic' renal impairment the initial dose should correspond to the previous level of chronic renal impairment).

 

Click on the antibiotic for details of each dose adjustment

A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z

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A

Aciclovir

Amikacin

Amoxicillin (IV Ampicillin no longer available at GHNHSFT)

Amphotericin - (Fungizone® and Ambisome®)

 

B

Benzylpenicillin

 

C

Caspofungin

Cefradine

Ceftazidime

Ceftriaxone

Cefuroxime IV

Ciprofloxacin

Clarithromycin

Clindamycin

Co-amoxiclav

Co-trimoxazole

 

D

Daptomycin

Doxycycline

 

E

Erythromycin

Ethambutol

 

F

Flucloxacillin

Fluconazole

Flucytosine

Fusidic acid

 

G

Gentamicin

 

H

 

I

Imipenem

Isoniazid

Itraconazole

 

J

 

K

 

L

Levofloxacin

Linezolid

 

M

Meropenem

Metronidazole

 

N

Nitrofurantoin

 

O

Oseltamivir

 

P

Penicillin V

 Piperacillin/tazobactam (Tazocin)

Pyrazinamide

 

Q

 

 R

Rifampicin

 

S

Sodium fusidate (Fusidic acid)

 

T

Tazocin

Teicoplanin

Tigecycline

Tobramycin

Trimethoprim

 

U

 

V

Vancomycin

Voriconazole

 

W

 

X

 

Y

 

Z